Imagine that a friend has suffered a terrible car accident. We are going to see him at the hospital and we realize that he is quite disoriented. We observe that he is unable to remember what happened to him in the accident. He claims that he has a mental gap that prevents him from accessing such information. When the days pass, little by little, it is recovering certain data, but not all. What is happening to our friend? Most likely, he suffers from localized and selective dissociative amnesia..
Throughout the article the diagnostic criteria of dissociative amnesia will be addressed, as well as the types that exist. The factors supporting the diagnosis, risk factors, functional consequences, comorbidity and treatment will also be presented. For this, the latest update of the Diagnostic and Statistical Manual of Mental Disorders will be followed (DSM, 2014). Let's get started!
- 1 Diagnostic criteria of dissociative amnesia
- 2 Characteristics and types of dissociative amnesia
- 3 Associated characteristics that support the diagnosis
- 4 Risk factors
- 5 Functional consequences of dissociative amnesia
- 6 Comorbidity
- 7 Treatment of dissociative amnesia
Diagnostic criteria of dissociative amnesia
- Presence of inability to remember important autobiographical information. As usual, It is usually traumatic or stressful in nature, which is incompatible with ordinary oblivion. This type of amnesia, in most cases, consists of localized or selective amnesia of a specific event or events. It can also consist of generalized amnesia of identity and life history.
- The symptoms of dissociative amnesia cause clinically significant discomfort or deterioration in the social, labor or other important areas of operation.
- Alterations cannot be attributed to the physiological effects of a substance or of another medical or neurological condition (for example, transient general amnesia, complex partial epilepsy, etc.).
- The alteration is not best explained by a dissociative anxiety disorder, a post-traumatic stress disorder, an acute stress disorder, a somatic symptom disorder or a major or mild neurocognitive disorder.
It should be specified whether dissociative amnesia presents with dissociative leakage, which consists of apparently wandering around with a disoriented purpose or wandering that is associated with identity amnesia or other important autobiographical information.
Characteristics and types of dissociative amnesia
In point 1 it is observed that there is an inability to remember important autobiographical information. At this point, it is important to note that it is about information that should be stored successfully in memory and that should normally be remembered without problems. This type of amnesia, differs from permanent amnesias in that it does not present neurobiological damage that prevents memory storage or recovery.
Localized and selective amnesia
Localized amnesia consists in the inability to remember events during a specific and short period of time.. It represents the most frequent form of dissociative amnesia. With respect to selective amnesia, the person can remember some events - but not all - for a specific period of time. That is, you can remember to remember some details of a traumatic event but not all. There are cases in which localized and selective amnesia occur together.
Generalized amnesia consists in the total loss of memory that covers the whole life of the person. It is a very rare type of amnesia. They can even forget their identity. They may also fail to remember facts about the world and access to well-learned skills can be greatly diminished. This type of amnesia usually has an acute onset in the form of perplexity, disorientation, ambulation, etc.
What population is more susceptible to this type of amnesia? War veterans, victims of sexual assault and those who experience conflict and / or extreme emotional stress. A large part of these patients are not aware of their problem.
Systematic and continuous amnesia
The systematized amnesia it is characterized because the individual loses his memory in a specific area of informationFor example, all the memories related to your work. In the continuous amnesia, the person forgets all new events that take place from a specific event to the present.
Associated features that support the diagnosis
A characteristic presented by individuals with dissociative amnesia is the chronic inability to maintain successful social relationships. Some background that individuals with this type of amnesia may present is mutilation, suicide attempts and high-risk behaviors. Depressive symptoms are frequent, as are functional neurological symptoms such as depersonalization. or autohypnotic symptoms.
Environmental factors. Among these types of factors we can find war conflicts, child abuse, natural disasters, internment in concentration camps, genocides, etc. Dissociative amnesia increases the likelihood of occurrence when a large number of adverse childhood experiences occur (especially physical or sexual abuse); or interpersonal violence takes place; or when there is an increase in the frequency, severity and violence of a particular trauma.
Genetic and physiological. Existing studies about dissociation suggest that there are significant genetic and environmental factors in both clinical and non-clinical samples. However, genetic studies on dissociative amnesia have not yet been carried out.
Functional consequences of dissociative amnesia
In both localized, selective or systematized dissociative amnesia, the deterioration ranges from limited to severe. Those who suffer from chronic generalized dissociative amnesia usually suffer from functional decline quite marked in your day to day. Although they re-learn some lost skills and numerous aspects of their life history, autobiographical memory remains very small. In many cases, they tend to become disabled on a professional and interpersonal level.
When individuals with dissociative amnesia usually begin to remit symptoms, a variety of affective alterations can occur as: dysphoria, grief, anger, shame, guilt, conflicts and psychological disorders, suicidal and homicidal ideation, impulses and acts. All this leads to them having symptoms that fit the diagnostic criteria of the persistent depressive disorder (dysthymia), major depressive disorder, other specified or unspecified depressive disorders, adjustment disorder with depressed mood, or adjustment disorder with mixed alteration of emotions.
Many of those who suffer dissociative amnesia, may develop a posttraumatic stress disorder (PTSD) at some point in his life. Above all, they can experience it when the traumatic background of their amnesia returns to the light of consciousness.
Treatment of dissociative amnesia
The treatment of dissociative amnesia can be of two types: psychological and pharmacological. For example, in terms of memory recovery, an environment that provides security and support to the subject is recommended. If this measure is not enough for the gradual recovery of memory, hypnosis or a semi-hypnotic state induced by medications such as benzodiazepines may be recommended.
It is very important that in the recovery of memory, the therapist or the doctor, avoid creating false memories. Once the patient begins to recover the memory and begins to remember events that can be traumatic, The psychologist can help manage problems related to memories of these types of events.
American Psychiatric Association. (2014). Diagnostic and Statistical Manual of Mental Disorders. Madrid: Pan American Medical Editorial.Related tests
- Depression test
- Goldberg depression test
- Self-knowledge test
- how do others see you?
- Sensitivity test (PAS)
- Character test